Interventional treatment for trigeminal neuralgia: Radiofrequency and neuromodulation

Abstract

Trigeminal neuralgia is initially managed pharmacologically. The selection of an interventional treatment is preceded by an accurate diagnosis with attention to vascular compression and potential neuropathy. Radiofrequency thermocoagulation of the Gasserian ganglion is well documented and preferred percutaneous treatment. There is evidence that efficacy and safety improve when the electrode placement is more precisely controlled, as with the neuronavigation techniques. The effect of pulsed radiofrequency treatment is shorter, but this treatment may be considered for patients at risk. When vascular compression is an important factor, microvascular decompression is preferred. On the other hand, neuromodulation may be indicated in cases of intractable neuropathy.